We are pleased to share for comment the draft provider manual and
Topics Related to Bulletins
Pegfilgrastim-bmez Injection, for Subcutaneous Use (Ziextenzo™) HCPCS Code J3590: Billing Guidelines
Effective with date of service Nov. 8, 2019, the NC Medicaid and NC Health Choice programs cover pegfilgrastim-bmez injection, for subcutaneous use (Ziextenzo) for use in the Physician Administered Drug Program when billed with HCPCS code J3590 - Unclassified biologics.
Effective with date of service Nov. 11, 2019, the NC Medicaid and NC Health Choice programs cover luspatercept-aamt for injection, for subcutaneous use (Reblozyl) for use in the Physician Administered Drug Program when billed with HCPCS code J3590 - Unclassified biologics.
Effective with date of service Nov. 26, 2019, the NC Medicaid and NC Health Choice programs cover givosiran injection, for subcutaneous use (Givlaari) for use in the Physician Administered Drug Program when billed with HCPCS code J3490 - Unclassified drugs.
Immune Globulin Intravenous, Human – Slra 10% Liquid (Asceniv™) HCPCS Code J1599: Billing Guidelines
Effective with date of service Nov. 18, 2019, the NC Medicaid and NC Health Choice programs cover immune globulin intravenous, human – slra 10% liquid (Asceniv) for use in the Physician Administered Drug Program when billed with HCPCS code J1599 - Injection, immune globulin, intravenous, non-lyophilized (e.g., liquid), not otherwise specified, 500 mg.
Effective with date of service Nov. 20, 2019, the NC Medicaid and NC Health Choice programs cover crizanlizumab-tmca injection, for intravenous use (Adakveo) for use in the Physician Administered Drug Program (when billed with HCPCS code J3590 - Unclassified biologics.
In response to the higher than normal number of influenza cases and influenza-related complications and deaths, NC Medicaid is offering telephonic evaluation and management services to beneficiaries who are actively experiencing flu-like symptoms.
NC Medicaid has received calls concerning claim denials for some services provided by nurse practitioners and physician assistants. NC Medicaid has provided instructions to NCTracks to update the claims processing system. The following procedure code list was recently updated to include additional NP and PA taxonomies.
The following new or amended clinical coverage policies are available on the NC Medicaid Clinical Coverage Policies web page.
NC-MIPS is Open for Program Year 2019, Reminder from CMS Regarding Objective 6 and Objective 7, Clarification from CMS Regarding Objective 5 Measure 1: Patient Electronic Access and general reminders.